Hello, My dad is diagnosed with Acute Lymphoblastic Leukemia BCell type. Philadelphia Chromosome negative and his report expressed CD20 marker. He was treated with modified gmall protocol. I would like to know if some other protocol would be better for him. And would using Rituximab as a combination with chemotherapy would help him better with the prognosis or is Rituximab only used after relapse. Please give an advise as Its hard to find doctors treating blood disorders. Thanks and Regards

Dr. Pritam MohapatraAlternative Medicine Specialist22yrs exp

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Hi lybrate-user, I appreciate you seeking help for your father. Is your father's treatment basis the Gmall protocol, already over? As far as I understand, targeted therapy with 'Rituximab' is used (often) along with chemotherapy for better clinical outcomes. This may be used either as a part of the initial treatment or as a part of the 2nd line treatment regimen. However, the decision to go for a targeted therapy is to be taken by your father's consulting physician/ haemato-oncologist, as would deem contextually appropriate. Above-mentioned apart, you may also evaluate options of an autologous/ allogenic stem cell transplant, once remission is achieved, with your haemato-oncologist. A stem cell transplant, if feasible in your father's case, may possibly help improve disease free survival. Should it require, please proceed for a second opinion suitably here. Simultaneously, also do note that an integrative treatment with natural/ alternative medicines is likely to influence outcomes too. Hope this helps. Do take care and all the very best.  

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